Patients set for MRSA screen before hospital entry

Published on Monday 13 August 2007 12:42

HEALTH chiefs in the Lothians believe all patients should be screened before they enter hospital to tackle superbugs.

Infections such as MRSA and clostridium difficile (C-diff) remain at a high rate, although they are on the decrease according to new figures.

Experts believe some people might already be carrying the bugs before they are admitted, despite the general assumption patients pick up the infections while in hospital.

The new chairman of NHS Lothian, Dr Charles Winstanley, has asked Health Secretary Nicola Sturgeon to discuss screening and she has offered her backing.

The initiative would see patients tested when entering hospital and then isolated from other patients if they proved positive for an antibiotic-resistant superbug.

As well as helping identify the source of the infection, this would prevent it spreading from patient to patient.

"If it emerges that high levels of MRSA or C-diff are prevalent in the community, it is likely a major awareness campaign would be needed to promote better hygiene in places such as care homes.

Dr Winstanley said: "Patients are right to be concerned if they think they're going to leave hospital with an infection they didn't go in with.

"Our figures are in line with national expectations - the actual rates are not cause for alarm, but I want to see the figures improve.

"I've taken up with the Scottish Executive the suggestion that we discuss the case for screening patients on arrival at hospital so that we get some idea of what's being taken in, as opposed to what might be picked up there.

"Screening already happens in a few high-risk specialities but it's not universal and I think there should be discussion on a standard arrangement across Scotland.

"Screening can take time and could cause some delay so it does create difficulties, but it would isolate which bits of MRSA were incubated at home and taken into hospital, and which bits were acquired in a hospital environment. I would have thought that's the first piece of information we need to know.

"It may be we're simply incubating levels of MRSA that are in the community."

Screening already takes place with vulnerable patients who undergo heart surgery or hip operations, but testing is limited due to the high cost involved.

It could cost as much as 20 million a year to screen all NHS Lothian patients on admission.

But Health Secretary Nicola Sturgeon said: "If experts give the go-ahead, I am determined that we will fund an MRSA screening programme."

New figures show that the number of MRSA cases fell from 234 in 2005/06 to 201 in the most recent financial year.

Cases of C-diff also fell, from 1571 to 1455, however instances of MSSA, a less deadly relative of MRSA, rose marginally, from 236 to 238.

A national surveillance report on C-diff found rates across Scotland rose by 50 per cent earlier this year, but the Lothians bucked the trend.

Dr Alison McCallum, director of public health with NHS Lothian, said: "We know from our figures and reports from other agencies that - through the hard work of our dedicated staff - we are continuing to keep the rate of healthcare-associated infections stable and have been doing so for the last five years.

"We are implementing a multifaceted strategy to control infections and would like to thank the public for their help in keeping infections out of hospital.

"Over the last couple of years, we have invested in 50,000 copies of a patient information booklet, a number of poster campaigns, the provision of alcohol gel dispensers and participated in national campaigns, led by the Scottish Executive, on hand hygiene."